Does Timing of VT Ablation Affect Prognosis in Patients With an Implantable Cardioverter-defibrillator?

NCT ID: NCT01547208

Last Updated: 2020-04-14

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

590 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-09-30

Study Completion Date

2022-09-30

Brief Summary

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The purpose of this study is to assess whether the burden of untreated non-sustained ventricular tachycardias (VTs), or episodes treated with anti-tachycardia pacing, correlates with appropriate implantable cardiac defibrillator (ICD) shock therapies and to evaluate if the timing of radiofrequency VT ablation affects the prognosis of ICD recipients.

Detailed Description

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Enrolled patients will remain in a first phase of the study until the first appropriate ICD shock will be delivered.

The objective of this first stage is to assess whether the burden of untreated non sustained VTs or episodes treated with anti-tachycardia pacing is predictive of appropriate ICD shocks.

The second phase of the study will start after the first appropriate ICD shock delivered for VT.

Patients will be then randomized to immediate VT ablation or to standard treatment, meaning waiting until next arrhythmic storm to perform a VT ablation procedure.

The objective of this phase is compare the rate of worsening heart failure hospitalizations and deaths from any cause between the two groups.

Conditions

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Ventricular Tachycardias

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Group A

Patients will be randomized to a VT ablation procedure immediately after an appropriate ICD shock

Group Type EXPERIMENTAL

Immediate radiofrequency ablation of ventricular tachycardia

Intervention Type PROCEDURE

Radiofrequency ablation of ventricular tachycardia is performed immediately after an appropriate ICD shock

Group B

Patients will wait until an arrhythmic storm to undergo a VT ablation procedure

Group Type ACTIVE_COMPARATOR

Radiofrequency ablation of ventricular tachycardia

Intervention Type PROCEDURE

Radiofrequency ablation of ventricular tachycardia will be performed after an arrhythmic storm occurs

Interventions

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Immediate radiofrequency ablation of ventricular tachycardia

Radiofrequency ablation of ventricular tachycardia is performed immediately after an appropriate ICD shock

Intervention Type PROCEDURE

Radiofrequency ablation of ventricular tachycardia

Radiofrequency ablation of ventricular tachycardia will be performed after an arrhythmic storm occurs

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Patients already implanted with ICD (single-/dual -chamber, with or without cardiac resynchronization therapy) for primary or secondary prevention of sudden cardiac death

Exclusion Criteria

* General contraindication to transcatheter ablation
* Contraindication to antithrombotic therapy
* Patients chronically treated with class I and III antiarrhythmic drugs


* Patients developing first occurrence of incessant VTs
* Patients receiving a shock for first occurrence of clinically verified ventricular fibrillation
* Patients with aetiology differing from ischemic heart disease for coronary artery disease and from non-ischemic dilatative cardiomyopathy
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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IRCCS San Raffaele

OTHER

Sponsor Role lead

Responsible Party

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Paolo Della Bella

Director of Arrhythmia Department and Clinical Electrophysiology Laboratories

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Paolo Della Bella

Role: STUDY_DIRECTOR

IRCCS San Raffaele

Andrea Radinovic

Role: STUDY_DIRECTOR

IRCCS San Raffaele

Locations

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Brussels Heart Center

Brussels, , Belgium

Site Status NOT_YET_RECRUITING

IKEM Hospital

Prague, , Czechia

Site Status NOT_YET_RECRUITING

Hôpital cardiologique du Haut-Lévêque

Bordeaux, , France

Site Status RECRUITING

Herz und Gefass Klinik

Bad Neustadt an der Saale, , Germany

Site Status RECRUITING

Ospedale di Desio

Desio, Milan, Italy

Site Status RECRUITING

Ospedale di Montebelluna

Montebelluna, Treviso, Italy

Site Status RECRUITING

Ospedale Mater Domini

Castellanza, Varese, Italy

Site Status RECRUITING

Azienda Ospedaliera Sant'Antonio Abate

Gallarate, Varese, Italy

Site Status RECRUITING

Ospedale di Mirano

Mirano, Venice, Italy

Site Status NOT_YET_RECRUITING

Ospedale S. Donato

Arezzo, , Italy

Site Status RECRUITING

AO Policlinico di Bari

Bari, , Italy

Site Status NOT_YET_RECRUITING

Ospedale Brotzu

Cagliari, , Italy

Site Status RECRUITING

Osp. Fondazione Giovanni Paolo II

Campobasso, , Italy

Site Status RECRUITING

AO Pugliese Ciaccio

Catanzaro, , Italy

Site Status RECRUITING

IRCCS San Raffaele

Milan, , Italy

Site Status RECRUITING

Fondazione G. Monasterio

Pisa, , Italy

Site Status RECRUITING

Policlinico Casilino

Rome, , Italy

Site Status RECRUITING

Azienda Ospedaliera Valtellina e Valchiavenna

Sondrio, , Italy

Site Status RECRUITING

Ospedale Civile Maggiore

Verona, , Italy

Site Status RECRUITING

Centro Hospitalar Lisboa Norte, Hospital Universitário de Santa Maria

Lisbon, , Portugal

Site Status RECRUITING

Lausanne Hospital

Lausanne, , Switzerland

Site Status RECRUITING

Countries

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Belgium Czechia France Germany Italy Portugal Switzerland

Central Contacts

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Andrea Radinovic

Role: CONTACT

Paolo Della Bella

Role: CONTACT

Facility Contacts

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Gaetano Paparella

Role: primary

Josef Kautzner

Role: primary

Pierre Jais

Role: primary

Thomas Deneke

Role: primary

Giuseppe Mantovani

Role: primary

Diego Vaccari

Role: primary

Massimo Tritto

Role: primary

Daniela Orsida

Role: primary

Franco Zoppo

Role: primary

Pasquale Notarstefano

Role: primary

Giuseppe Grandinetti

Role: primary

Gianfranco Tola

Role: primary

Matteo Santamaria

Role: primary

Giampiero Maglia

Role: primary

Andrea Radinovic

Role: primary

Marcello Piacenti

Role: primary

Alessio Borrelli

Role: primary

Maurizio Moizi

Role: primary

Giovanni Morani

Role: primary

Luis Carpinteiro

Role: primary

Etienne P Pruvot

Role: primary

References

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Reddy VY, Reynolds MR, Neuzil P, Richardson AW, Taborsky M, Jongnarangsin K, Kralovec S, Sediva L, Ruskin JN, Josephson ME. Prophylactic catheter ablation for the prevention of defibrillator therapy. N Engl J Med. 2007 Dec 27;357(26):2657-65. doi: 10.1056/NEJMoa065457.

Reference Type BACKGROUND
PMID: 18160685 (View on PubMed)

Kuck KH, Schaumann A, Eckardt L, Willems S, Ventura R, Delacretaz E, Pitschner HF, Kautzner J, Schumacher B, Hansen PS; VTACH study group. Catheter ablation of stable ventricular tachycardia before defibrillator implantation in patients with coronary heart disease (VTACH): a multicentre randomised controlled trial. Lancet. 2010 Jan 2;375(9708):31-40. doi: 10.1016/S0140-6736(09)61755-4.

Reference Type BACKGROUND
PMID: 20109864 (View on PubMed)

Sweeney MO, Sherfesee L, DeGroot PJ, Wathen MS, Wilkoff BL. Differences in effects of electrical therapy type for ventricular arrhythmias on mortality in implantable cardioverter-defibrillator patients. Heart Rhythm. 2010 Mar;7(3):353-60. doi: 10.1016/j.hrthm.2009.11.027. Epub 2009 Dec 2.

Reference Type BACKGROUND
PMID: 20185109 (View on PubMed)

Poole JE, Johnson GW, Hellkamp AS, Anderson J, Callans DJ, Raitt MH, Reddy RK, Marchlinski FE, Yee R, Guarnieri T, Talajic M, Wilber DJ, Fishbein DP, Packer DL, Mark DB, Lee KL, Bardy GH. Prognostic importance of defibrillator shocks in patients with heart failure. N Engl J Med. 2008 Sep 4;359(10):1009-17. doi: 10.1056/NEJMoa071098.

Reference Type BACKGROUND
PMID: 18768944 (View on PubMed)

Varma N, Epstein AE, Irimpen A, Schweikert R, Love C; TRUST Investigators. Efficacy and safety of automatic remote monitoring for implantable cardioverter-defibrillator follow-up: the Lumos-T Safely Reduces Routine Office Device Follow-up (TRUST) trial. Circulation. 2010 Jul 27;122(4):325-32. doi: 10.1161/CIRCULATIONAHA.110.937409. Epub 2010 Jul 12.

Reference Type BACKGROUND
PMID: 20625110 (View on PubMed)

Varma N, Michalski J, Epstein AE, Schweikert R. Automatic remote monitoring of implantable cardioverter-defibrillator lead and generator performance: the Lumos-T Safely RedUceS RouTine Office Device Follow-Up (TRUST) trial. Circ Arrhythm Electrophysiol. 2010 Oct;3(5):428-36. doi: 10.1161/CIRCEP.110.951962. Epub 2010 Aug 17.

Reference Type BACKGROUND
PMID: 20716717 (View on PubMed)

Gilliam FR, Hayes DL, Boehmer JP, Day J, Heidenreich PA, Seth M, Jones PW, Stein KM, Saxon LA. Real world evaluation of dual-zone ICD and CRT-D programming compared to single-zone programming: the ALTITUDE REDUCES study. J Cardiovasc Electrophysiol. 2011 Sep;22(9):1023-9. doi: 10.1111/j.1540-8167.2011.02086.x. Epub 2011 May 31.

Reference Type BACKGROUND
PMID: 21627705 (View on PubMed)

Carbucicchio C, Santamaria M, Trevisi N, Maccabelli G, Giraldi F, Fassini G, Riva S, Moltrasio M, Cireddu M, Veglia F, Della Bella P. Catheter ablation for the treatment of electrical storm in patients with implantable cardioverter-defibrillators: short- and long-term outcomes in a prospective single-center study. Circulation. 2008 Jan 29;117(4):462-9. doi: 10.1161/CIRCULATIONAHA.106.686534. Epub 2008 Jan 2.

Reference Type BACKGROUND
PMID: 18172038 (View on PubMed)

Della Bella P, Baratto F, Tsiachris D, Trevisi N, Vergara P, Bisceglia C, Petracca F, Carbucicchio C, Benussi S, Maisano F, Alfieri O, Pappalardo F, Zangrillo A, Maccabelli G. Management of ventricular tachycardia in the setting of a dedicated unit for the treatment of complex ventricular arrhythmias: long-term outcome after ablation. Circulation. 2013 Apr 2;127(13):1359-68. doi: 10.1161/CIRCULATIONAHA.112.000872. Epub 2013 Feb 25.

Reference Type BACKGROUND
PMID: 23439513 (View on PubMed)

Vergara P, Trevisi N, Ricco A, Petracca F, Baratto F, Cireddu M, Bisceglia C, Maccabelli G, Della Bella P. Late potentials abolition as an additional technique for reduction of arrhythmia recurrence in scar related ventricular tachycardia ablation. J Cardiovasc Electrophysiol. 2012 Jun;23(6):621-7. doi: 10.1111/j.1540-8167.2011.02246.x. Epub 2012 Apr 4.

Reference Type BACKGROUND
PMID: 22486970 (View on PubMed)

Della Bella P, Baratto F, Vergara P, Bertocchi P, Santamaria M, Notarstefano P, Calo L, Orsida D, Tomasi L, Piacenti M, Sangiorgio S, Pentimalli F, Pruvot E, De Sousa J, Sacher F, Tritto M, Rebellato L, Deneke T, Romano SA, Nesti M, Gargaro A, Giacopelli D, Peretto G, Radinovic A. Does Timing of Ventricular Tachycardia Ablation Affect Prognosis in Patients With an Implantable Cardioverter Defibrillator? Results From the Multicenter Randomized PARTITA Trial. Circulation. 2022 Jun 21;145(25):1829-1838. doi: 10.1161/CIRCULATIONAHA.122.059598. Epub 2022 Apr 3.

Reference Type DERIVED
PMID: 35369700 (View on PubMed)

Kheiri B, Barbarawi M, Zayed Y, Hicks M, Osman M, Rashdan L, Kyi HH, Bachuwa G, Hassan M, Stecker EC, Nazer B, Bhatt DL. Antiarrhythmic Drugs or Catheter Ablation in the Management of Ventricular Tachyarrhythmias in Patients With Implantable Cardioverter-Defibrillators: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Circ Arrhythm Electrophysiol. 2019 Nov;12(11):e007600. doi: 10.1161/CIRCEP.119.007600. Epub 2019 Nov 8.

Reference Type DERIVED
PMID: 31698933 (View on PubMed)

Other Identifiers

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PARTITA

Identifier Type: -

Identifier Source: org_study_id

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